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Mortensen AH, Nåden D, Karterud D, Gallagher A, Lohne V. A qualitative study of family members' perspectives regarding decision-making for nursing home residents' care. Int J Qual Stud Health Well-being 2024; 19:2370545. [PMID: 38905141 PMCID: PMC11195484 DOI: 10.1080/17482631.2024.2370545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 06/17/2024] [Indexed: 06/23/2024] Open
Abstract
PURPOSE We explored how family caregivers perceive decision-making regarding the care of nursing home residents. METHODS This qualitative study used Flemming's Gadamerian-based research method. In person semi-structured interviews about decision-making concerning residents' care were conducted with 13 family members (nine women, four men) of residents of three Norwegian nursing homes. FINDINGS The following themes emerged: Excessive focus on autonomy threatens resident wellbeing and safety. Resident wellbeing is the caregiver's responsibility. Resident wellbeing serves as a guiding principle. CONCLUSIONS The family members of residents and the nursing home caregivers disagreed about the significance of upholding resident autonomy to respect residents' dignity. The family members held that not all instances where residents refused care reflect autonomy situations as care refusal often does not reflect the resident's true values and standards but rather, stems from barriers that render necessary care actions difficult. In situations where residents refuse essential care or when the refusal does not align with the residents second-order values, the family members suggested that caregivers strive to understand the causes of refusal and seek non-coercive ways to navigate it. Hence, the family members seemed to endorse the use of soft paternalism in nursing homes to safeguard residents' wellbeing and dignity.
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Affiliation(s)
- Anne Helene Mortensen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet, Oslo, Norway
| | - Dagfinn Nåden
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet, Oslo, Norway
| | - Dag Karterud
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet, Oslo, Norway
| | - Ann Gallagher
- Department of Health Sciences, Brunel University London, London, UK
| | - Vibeke Lohne
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet, Oslo, Norway
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Bae S, Kim D. Improving home-like environments in long-term care units: an exploratory mixed-method study. Sci Rep 2024; 14:13243. [PMID: 38853152 PMCID: PMC11162995 DOI: 10.1038/s41598-024-62328-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/15/2024] [Indexed: 06/11/2024] Open
Abstract
Although the number of older adults requiring care is rapidly increasing, nursing homes have long faced issues such as the absence of a home-like environment. This exploratory mixed-method study investigated how residents (n = 15) in a long-term care unit in South Korea perceive home-like features and privacy in their living spaces. The results indicated that most participants were satisfied with the homeliness and privacy of their environment, but some were unhappy with the level of privacy. Most participants had low scores on the Geriatric Depression Scale and the Pittsburgh Sleep Quality Index, indicating low levels of depression and sleep disorders. Sleep quality was affected by factors such as sensory environment, staff visits, and room temperature. Although participants appreciated social support and private rooms, they expressed a desire for larger rooms. Overall, this study provides preliminary insights into older adults' views on their living spaces in long-term care with implications for improving their quality of life.
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Affiliation(s)
- Suyeon Bae
- Department of Housing and Interior Design, Age Tech-Convergence Major, Kyung Hee University, Seoul, South Korea.
| | - Dayoung Kim
- Department of Housing and Interior Design, Age Tech-Convergence Major, Kyung Hee University, Seoul, South Korea
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Kim D, Hong Y, Chang SO. Ways of interdisciplinary approaches to advocating for nursing home residents with dementia. J Adv Nurs 2024. [PMID: 38771071 DOI: 10.1111/jan.16251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/04/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
AIM To explore how nursing home staff advocate for residents with dementia. DESIGN Phenomenographic qualitative research. METHODS Twenty nursing home staff from four disciplines (six nurses, four physical therapists, five social workers and five care workers) were purposively recruited from three different nursing homes. Data were collected through semi-structured interviews conducted from February 2023 to March 2023, and the analysis followed the sequential steps of phenomenographic analysis. RESULTS The analysis identified five categories of description: focusing on what happened, finding the gaps in perspectives, how to bridge for finding a common perspective, how to tailor care such that each resident receives equitable care and how to establish interdisciplinary sharing for a consistent advocative pattern. Their structural relationship was also identified as an outcome space. CONCLUSION The cyclical advocacy structure illustrated that nursing home staff engage in an ongoing process of advocacy during conflict situations as part of interdisciplinary care, emphasizing continuity of care rather than separate occurrences of care. IMPLICATIONS FOR THE PROFESSION This study revealed that, in advocating for residents with dementia, nursing home staff adopted an approach that fosters consistent care and proactive prevention, achieved through the formation of shared knowledge applicable uniformly across similar situations. IMPACT This study contributes significantly to the continuing education or training of interdisciplinary staff in nursing homes. The revelations of the study hold significance not only for the practical application but also for the theoretical advancement of concepts related to safeguarding the dignity, human rights and personhood of residents with dementia, with the ultimate goal of enhancing their quality of life within nursing homes. REPORTING METHOD Reporting complied with the COREQ criteria for qualitative research. PATIENT OR PUBLIC CONTRIBUTION Nursing home directors have contributed to the validation of data analysis and interpretation.
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Affiliation(s)
- Dayeong Kim
- College of Nursing and L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Youjung Hong
- College of Nursing and L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Sung Ok Chang
- College of Nursing and L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, Seoul, Republic of Korea
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Misiak MM, Bethell J, Chapman H, Sommerlad A. How can care home activities facilitate social connection in residents? A qualitative study. Aging Ment Health 2024:1-10. [PMID: 38669150 DOI: 10.1080/13607863.2024.2345130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Good social connection is associated with better physical and mental health but care home residents experience barriers to social connection. Activities present a potential avenue for improving social connection in care homes but residents often experience loneliness despite access to activity programmes. We therefore aimed to identify what aspects of activities facilitate social connection in care home residents. METHOD Qualitative study using semi-structured interviews that were analysed using Thematic Analysis. A purposive sample of 35 participants, including 12 residents, 10 family caregivers, nine care home staff and four clinicians, recruited from UK care homes. RESULTS We found four main themes describing features of activities important for facilitating social connection: (1) personalisation with respect to residents' interests, social preferences, and cognitive ability; (2) activities which foster a sense of community; (3) finding and emphasising things in common that residents share; and (4) facilitating a sense of involvement with others. CONCLUSION We identified the key aspects of activities which facilitate social connection in care homes. These findings can be applied to a range of existing and newly designed activities in care homes and inform the development and testing of psychosocial interventions aiming to improve social connection.
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Affiliation(s)
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute,University Health Network, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | - Andrew Sommerlad
- Division of Psychiatry, University College London, UK
- Division of Psychiatry, Camden and Islington NHS Foundation Trust, London, UK
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Baxter R, Corneliusson L, Björk S, Edvardsson D. Promoting resident thriving in nursing homes: A qualitative study. J Adv Nurs 2024. [PMID: 38661264 DOI: 10.1111/jan.16206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/22/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
AbstractAimTo explore how staff promote resident thriving in an Australian nursing home.DesignQualitative research design using content analysis.MethodsInterviews were held with 14 nursing staff working in an Australian nursing home in March/April 2018. Data were analysed using qualitative content analysis.ResultsFour themes were revealed: promoting personalized care; promoting opportunities for autonomy; promoting connection and meaning; and promoting a curated environment.ConclusionsStaff promoted resident thriving in relation to everyday care, activities, capabilities, relationships and the lived environment. Interventions that were perceived to promote thriving were described relative to the nurse, the resident, the care team and the wider nursing home context.Implications for the Profession and/or Patient CareThe findings provide novel insight into the understanding and application of the concept of thriving in long‐term care from nursing staffs' perspective.ImpactWhat Problem did the Study Address?Nursing home staff are uniquely positioned to support resident thriving through person‐centred care, yet little is known about how staff support promotion of thriving for nursing home residents in their everyday practice.What were the Main Findings?Nursing home staff perceived that they promoted thriving by personalizing care and supporting autonomy, connection, meaning and pleasure for residents.Where and on Whom will the Research have an Impact?These findings are of interest for the clinicians, educators and researchers who develop, implement and evaluate interventions to improve place‐related well‐being in nursing homes.Reporting MethodCORE‐Q checklist.Patient or Public ContributionNo patient or public contribution occurred for this study as this research focused on exploring staffs' perspectives from the specific viewpoint of their personal experience.
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Affiliation(s)
| | | | - Sabine Björk
- Department of Nursing, Umeå University, Umeå, Sweden
| | - David Edvardsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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Cucuzzella C, Rasoulivalajoozi M, Farzamfar G. Spatial experience of cancer inpatients in the oncology wards: A qualitative study in visual design aspects. Eur J Oncol Nurs 2024; 70:102552. [PMID: 38518630 DOI: 10.1016/j.ejon.2024.102552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/14/2024] [Accepted: 03/03/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE This paper aims to explore how the visual characteristics of cancer wards' interior spaces can be improved based on the combined visual design themes to help cancer inpatients' spatial experience and relieved state of mind. Accordingly, we present a visual design framework that can be applied in oncology wards. METHOD This study adopts the Ulrich-supportive design theory as a theoretical framework using two main methodological phases: observation of cancer wards and interviews with professional caregivers. The first phase critically explores hospital cancer wards' interactive aesthetical and visual interior characteristics. Next, we adjusted the visual criteria based on the Post Occupation Evaluation (POE) method to develop the interview questions. Interviews were conducted with experienced nurses, oncologists, and a general physician, all from a cancer ward at McGill University Health Center (MUHC) in Montreal, Canada. RESULTS We presented 11 main themes in the categories of color and light, natural/artistic images, way-finding, and visual clutter. To present and justify our visual design framework, these main themes were then classified based on the common goals, resulting in four combined themes: applying simplicity and usability; developing naturality; creating homeyness and respecting patients' agency; and promoting trustworthiness. CONCLUSION Our findings suggest that-apart from the last theme, promoting trustworthiness, the rest are in line with Ulrich's supportive design theory. Therefore, further research is needed to investigate "promoting trustworthiness" in the context of cancer wards. In addition, each aspect of the visual design framework can offer practical design recommendations for future studies.
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Affiliation(s)
- Carmela Cucuzzella
- Faculty of Environmental Design, University of Montreal, Montreal, Canada.
| | | | - Golriz Farzamfar
- Department of Design and Computation Arts, Concordia University. Montreal, Canada.
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Falcão Duarte C, Daalhuizen J, Schwennesen N. Ambiguities in Preventing Infections in Nursing Homes: Care Workers Experiences and Implications for Future Policies. J Aging Soc Policy 2024:1-22. [PMID: 38393974 DOI: 10.1080/08959420.2024.2320049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/16/2024] [Indexed: 02/25/2024]
Abstract
Preventing infections in nursing homes is highly challenging, given the ambiguous nature of nursing homes as care institutions and places to live. Yet, little is known about how care workers experience preventing infections in this context. Understanding the ambiguities experienced by care workers in nursing homes when enacting infection prevention is crucial to preparing for future health crises. This study investigates and identifies the ambiguities care workers faced and experienced when preventing infections during the COVID-19 pandemic. Interviews and observations were combined to capture narratives and behaviors related to infection prevention and care work. By using thematic analysis, three types of ambiguity were identified: (a) an Ambiguous sense of purpose, (b) Environmental ambiguity, and (c) Information ambiguity. The findings provide a nuanced understanding of the ambiguities care workers face and experience in nursing homes when preventing infections and indicate that such ambiguities impact their behaviors and attitudes. From this study, it is possible to conclude that policymakers must consider nursing homes' ambiguous characteristics in infection prevention programs.
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Affiliation(s)
- Carolina Falcão Duarte
- Department of Technology, Management and Economics, Technical University of Denmark, Lyngby, Denmark
| | - Jaap Daalhuizen
- Department of Technology, Management and Economics, Technical University of Denmark, Lyngby, Denmark
| | - Nete Schwennesen
- Department of People and Technology, Roskilde University, Roskilde, Denmark
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Backman A, Ahnlund P, Lövheim H, Edvardsson D. Nursing home managers' descriptions of multi-level barriers to leading person-centred care: A content analysis. Int J Older People Nurs 2024; 19:e12581. [PMID: 37859588 DOI: 10.1111/opn.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 09/12/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Research suggests that person-centred care can be beneficially implemented and sustained, even though barriers remain that prevent uptake in clinical practice. Understanding barriers to person-centred care seems important, as this has an impact on care practices and resident outcomes. Moreover, there is limited knowledge about nursing home managers' descriptions of barriers when leading person-centred care. OBJECTIVES To explore barriers to leading person-centred care as narrated by nursing home managers. METHODS A descriptive qualitative design was used to collect data using individual interviews with 12 nursing home managers in highly person-centred nursing homes. Data were analysed using content analysis. RESULTS Multi-level barriers to leading person-centred care were identified on the (1) person level, (2) team level and (3) organisational level. Placing professional and family considerations ahead of resident considerations was described as a barrier on the personal level (1). Also, staff's divergent care values, processes, and priorities together with turnover and low foundational knowledge were identified as barriers on the team level (2). On an organisational level (3), constrained finances, functional building design and group level rostering were identified as barriers. CONCLUSION Multi-level barriers influence nursing home managers' ability to lead and promote person-centred care. Promoting the development of person-centred practices requires efforts to eliminate barriers on person, team and organisational level. IMPLICATIONS FOR PRACTICE Identifying and overcoming barriers at various levels in nursing home care has the potential to promote person-centred practices. This study can inform stakeholders and policymakers of challenges and complexities in person-centred practices. Multi-level strategies are needed to target challenges at person-, team- and organisational level when striving to develop person-centred care.
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Affiliation(s)
| | - Petra Ahnlund
- Department of Social work, Umeå University, Umeå, Sweden
| | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine in Umeå, Umeå, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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Kiwi M. Away from Home or Returned Home? What Iranian Participants with Dementia Experience while Living in a Culturally Profiled Nursing Home in Sweden. J Cross Cult Gerontol 2023; 38:343-370. [PMID: 37994982 PMCID: PMC10689522 DOI: 10.1007/s10823-023-09490-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/24/2023]
Abstract
This study explores Iranian immigrants with dementia living in a culturally profiled Swedish nursing home and what it means to be at "home." The meaning given to a place, in general, is understood to be generated and formed by experiences, expectations, hopes, and chains of events, and its significance can change over time. Life changes will mainly affect the understanding of what constitutes "home." Such a concept can be challenging to define, especially amongst some immigrant populations and those with dementia, for whom parameters change and choice can be limited. This qualitative research study is based on ethnographic fieldwork following ten participants. The data was analyzed, and three main categories that contribute to understanding "home" as part of the delivery of care to elderly immigrants with dementia, namely "a place to escape to", "a place to be", and "a place to live", were identified. The findings show that living in a culturally profiled nursing home in Sweden gave residents a feeling of self-rule, although the institution did have its codes and rules. Considering the feeling of home, none of the participants felt at home; instead, they stated that the culturally profiled nursing home was merely a place to live. Factors that strengthened their independence were the ability to speak the language they were familiar with and receiving medical help without relying on their children.
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Affiliation(s)
- Mahin Kiwi
- Department of Health, Medicine and Caring Sciences, Linköpings University, 601 74, Norrköping, Sweden.
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10
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Groenvynck L, Khemai C, de Boer B, Beaulen A, Hamers JPH, van Achterberg T, van Rossum E, Meijers JMM, Verbeek H. The perspectives of older people living with dementia regarding a possible move to a nursing home. Aging Ment Health 2023; 27:2377-2385. [PMID: 37099667 DOI: 10.1080/13607863.2023.2203693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND/OBJECTIVES Moving into a nursing home is often an unavoidable life event for older people living with dementia. It is associated with negative emotions and outcomes. Research capturing their perspectives is scarce. This study aims to identify how older people living with dementia perceive a potential life in a nursing home and to understand their (future) care wishes. MATERIALS AND METHODS This study is part of the European TRANS-SENIOR research network. The study followed a qualitative phenomenological methodology. Semi-structured interviews with 18 community-dwelling older people living with dementia were conducted between August 2018 and October 2019 (METCZ20180085). A stepwise interpretive phenomenological analysis was performed. RESULTS The majority of community-dwelling older people feared the idea of potentially moving to a nursing home. The participants associated a possible move with negative perceptions and emotions. Additionally, this study emphasized the importance of knowledge of current and past experiences with care when identifying the participant's wishes. They wanted to remain (a) individuals, who are (b) autonomous and have (c) social contacts if they would move to a nursing home. DISCUSSION/IMPLICATIONS This study showed how past and current care experiences can educate/inform healthcare professionals on the future care wishes of older people living with dementia. The results indicated that listening to the wishes, and life stories of people living with dementia could be a way of identifying 'a suitable time' to suggest a move to a nursing home. This could improve the transitional care process and adjustment to living in a nursing home.
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Affiliation(s)
- Lindsay Groenvynck
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Chandni Khemai
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Bram de Boer
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Audrey Beaulen
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Jan P H Hamers
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Erik van Rossum
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Zuyd University of Applied Sciences, Academy of Nursing, Research centre on Community Care, Heerlen, The Netherlands
| | - Judith M M Meijers
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Zuyderland Care, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Hilde Verbeek
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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Tan JDL, Maneze D, Montayre J, Ramjan LM, Wang D, Salamonson Y. Family visits and depression among residential aged care residents: An integrative review. Int J Nurs Stud 2023; 146:104568. [PMID: 37597458 DOI: 10.1016/j.ijnurstu.2023.104568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 07/10/2023] [Accepted: 07/22/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Depression in older people living in residential aged care is a serious and highly prevalent health issue, with loneliness and social isolation being major contributors. The COVID-19 pandemic underscored the harm visiting restrictions have on the mental wellbeing of older people in residential aged care. However, there is a need to systematically review the relationship between family visits and depression in this population. OBJECTIVE This literature review seeks to explore the association between family visits and depression among those living in residential aged care. METHODS An integrative review was conducted in March 2022, based on a search of seven databases from inception to 2022. Papers were included if the studies were situated in a residential aged care facility and explored the impact of in-person family visits on depression of residents. Those that examined impact of family visits on community-dwelling older people and papers examining virtual family visits were excluded. The quality of the included papers was assessed using appropriate critical appraisal tools. Guided by the aim of this study, the included papers were narratively synthesised and presented thematically (PROSPERO ID CRD42022325895). RESULTS Ten papers, published between 1991 and 2022, were included in the final synthesis. Multiple categorisations of frequency of visits and different scales were used to assess depression. Depression among residents in aged care facilities varied from 20 % to 58.7 % with 40 % of studies showing a positive association between the frequency of family visits and lower rate of depression. Three themes influencing the association between family visits and depression in residential aged care were identified. These were: (i) intersection of culture, filial values, and depression; (ii) resident-related factors including whether admission was voluntary and presence of functional impairment; and (iii) non-resident-related factors such as social activities for residents and staff involvement. CONCLUSION Family visits ameliorated loneliness and depression among residents in aged care however, other factors such as culture, comorbidities and functional impairment, opportunities for socialisation and the social involvement of facility staff also influenced depression. Whilst the low number of studies reviewed limited comparison and generalisation of results, the review highlighted the broader and crucial role of healthcare staff in facilitating socialisation and promoting mental wellbeing of residents especially those who are not visited by families. TWEETABLE ABSTRACT Family visits ameliorate depression in institutionalised older people but may not be the "silver bullet" as depression is multifactorial.
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Affiliation(s)
- Josh D L Tan
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
| | - Della Maneze
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Joanna Briggs Institute, Sydney, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia; School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Lucie M Ramjan
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Donna Wang
- School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
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Stokke R, Wibe T, Sogstad M. Forming Nursing Home Practices That Support Quality of Care for Residents. A Qualitative Observational Study. J Multidiscip Healthc 2023; 16:2667-2680. [PMID: 37720269 PMCID: PMC10503513 DOI: 10.2147/jmdh.s426913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023] Open
Abstract
Background Residents of nursing homes are increasingly frail and dependent. At the same time, there are increased demands for quality of care and social life for individual residents. In this article, we explore how care workers contribute to quality of care and social life in shared living rooms in nursing homes. Methods An ethnographically inspired design was applied, and a purposive sample of six units for long-term care in three nursing homes in Norway was included in the study. Data were collected by participant observation, including informal conversations with the staff and residents, and the data were analyzed using thematic analysis. Results The analysis identified three main themes: working within the given context, creating care practices and organizing activities. The empirical findings demonstrate that care work focuses on meeting both the residents' physical and social needs and aiming for high-quality care and social life for the residents in nursing homes. Conclusion The results of this study illustrate that nursing home practices are focused on residents as a group. However, care workers take advantage of personal skills and resources to work towards person-centred care within the given context. The quality of care is recognized in terms of how care workers meet individual residents' needs. The quality of care seems highly related to the capability and skills of individual care workers.
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Affiliation(s)
- Randi Stokke
- Faculty of Medicine and Health Sciences, Centre for Care Research, Norwegian University of Science and Technology NTNU, Gjøvik, Norway
| | - Torunn Wibe
- Centre for Development of Institutional and Home Care Services in Oslo, Oslo, Norway
| | - Maren Sogstad
- Faculty of Medicine and Health Sciences, Centre for Care Research, Norwegian University of Science and Technology NTNU, Gjøvik, Norway
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Guimarães MRC, Giacomin KC, Ferreira RC, Vargas AMD. Evaluation of Long-Term Institutions for Older People in Brazil: an overview of regional inequalities. CIENCIA & SAUDE COLETIVA 2023; 28:2035-2050. [PMID: 37436317 DOI: 10.1590/1413-81232023287.15792022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/05/2023] [Indexed: 07/13/2023] Open
Abstract
This article aims to evaluate the Brazilian Long-Term Institutions for Older People (LTIE), according to the Integrated Multidimensional Theoretical Model of Quality and Service (MIQA), and compare the performance achieved between the regions of the country. Descriptive ecological study carried out with public secondary data from the LTIE participating in the 2018 Census of the Unified Social Assistance System. An Evaluation Matrix was constructed from the Census variables and the MIQA Theoretical Model. Quality parameters were used to classify the institutions' performance for each indicator as "incipient", "developing" or "desirable". The disparity index was obtained for each indicator. 1,665 institutions were analyzed. Differences were observed in the percentages of LTIE with "desirable" performance between Brazilian regions, and the need for improvement in most LTIE in relation to the proportion of caregivers of older people, the composition of the multidisciplinary team, accessibility and supply of health promotion actions. There was a need for government support for the suppression of exclusionary differentiation criteria and for the expansion of services to overcome overcrowding.
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Affiliation(s)
- Mirna Rodrigues Costa Guimarães
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Karla Cristina Giacomin
- Secretaria Municipal de Saúde, Prefeitura Municipal de Belo Horizonte. Belo Horizonte MG Brasil
| | - Raquel Conceição Ferreira
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
| | - Andrea Maria Duarte Vargas
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-901 Belo Horizonte MG Brasil.
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Verderber S, Koyabashi U, Cruz CD, Sadat A, Anderson DC. Residential Environments for Older Persons: A Comprehensive Literature Review (2005-2022). HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:291-337. [PMID: 37078127 PMCID: PMC10328148 DOI: 10.1177/19375867231152611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND Independent noninstitutional and institutional residential long-term care environments for older persons have been the subject of significant empirical and qualitative research in the 2005-2022 period. A comprehensive review of this literature is reported, summarizing recent advancements in this rapidly expanding body of knowledge. PURPOSE AND AIM This comprehensive review conceptually structures the recent literature on environment and aging to provide conceptual clarity and identify current and future trends. METHOD AND RESULT Each source reviewed was classified as one of the five types-opinion piece/essay, cross-sectional empirical investigation, nonrandomized comparative investigation, randomized study, and policy review essay-within eight content categories: community-based aging in place; residentialism; nature, landscape, and biophilia; dementia special care units; voluntary/involuntary relocation; infection control/COVID-19, safety/environmental stress; ecological and cost-effective best practices; and recent design trends and prognostications. CONCLUSIONS Among the findings embodied in the 204 literature sources reviewed, all-private room long-term care residential units are generally safer and provide greater privacy and personal autonomy to residents, the deleterious impacts of involuntary relocation continue, family engagement in policy making and daily routines has increased, multigenerational independent living alternatives are increasing, the therapeutic role of nature and landscape is increasingly well-documented, ecological sustainability has increased in priority, and infection control measures are of high priority in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review sets the stage for further research and design advancements on this subject in light of the rapid aging of societies around the globe.
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Affiliation(s)
- Stephen Verderber
- Centre for Design + Health Innovation, John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Umi Koyabashi
- Centre for Design + Health Innovation, John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Catherine Dela Cruz
- John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Aseel Sadat
- John H. Daniels Faculty of Architecture, Landscape and Design, University of Toronto, Ontario, Canada
| | - Diana C. Anderson
- Boston University School of Medicine, MA, USA
- Jacobs, Dallas, TX, USA
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15
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Falzarano FB, Cimarolli V, Siedlecki KL. Staying in the loop: Quality of family-paid caregiver communication and influences on resident mental health in long-term care. J Am Geriatr Soc 2023; 71:1209-1219. [PMID: 36514200 PMCID: PMC10089968 DOI: 10.1111/jgs.18184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 11/18/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Considerable research has examined communication dynamics among family members and staff in nursing homes (NHs) and has demonstrated that better communication is associated with more optimal mental health outcomes in both family caregivers and paid caregivers. However, the literature on how communication dynamics influence mental health in long-term care residents is limited and it has yet to be determined how communication impacts residents across care contexts, such as assisted living facilities (ALFs). The purpose of this study is to examine family caregivers' perceptions of communication with paid caregivers and its influence on long-term care resident outcomes and to compare how results differ across care settings (NHs vs. ALFs). METHODS Data were drawn from a subsample of the National Health and Aging Trends Study (NHATS) and the National Study on Caregiving (NSOC). The sample consisted of 142 NHATS participants residing in long-term care (n = 93 ALF residents; n = 49 NH residents) with an eligible family caregiver who participated in the NSOC. Family caregivers' perceived quality of communication was assessed via questions regarding the frequency, availability, and helpfulness of communication with paid caregivers. Resident mental health was assessed via measures of positive and negative affect, depressive symptoms, and anxiety. RESULTS Across the total sample, greater availability of communication between paid and family caregivers was associated with lower depressive symptoms and negative affect in residents. When examining how these relationships varied across care settings, communication was a stronger predictor of fewer depressive symptoms among residents in ALF settings. CONCLUSIONS Study findings provide insights into how interpersonal dynamics between family and paid caregivers influence resident mental health and underscore the importance of enhanced communication among all members of the primary care team, that is, paid caregivers, residents, and their family members.
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Affiliation(s)
- Francesca B Falzarano
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
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16
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Orr N, Abbott R, Bethel A, Paviour S, Whear R, Garside R, Coon JT. What are the effects of animals on the health and wellbeing of residents in care homes? A systematic review of the qualitative and quantitative evidence. BMC Geriatr 2023; 23:170. [PMID: 36964508 PMCID: PMC10038779 DOI: 10.1186/s12877-023-03834-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/16/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND There is some evidence to suggest that animal-assisted interventions can have beneficial impact for residents in long-term care, but the focus of the evidence has largely been on behavioural and psychosocial measured outcomes. Animals, either as companion animals or in the form of pet/animal-assisted therapy, may provide benefits in the form of social contact, as well as opportunities for sensory experiences and meaningful engagement not picked up by outcome tools. This review aimed to create a state-of-knowledge synthesis, bringing together qualitative and quantitative findings, on the impact of animal-human interaction on care home residents and care home staff. METHODS Fourteen databases were searched from inception to July 2020. Forward and backward citation chasing of included articles was conducted. Screening was undertaken independently by a team of reviewers. Thematic synthesis and meta-analysis were used to synthesise the qualitative and quantitative data. RESULTS Thirty-four studies, published in 40 articles (20 qualitative and 20 quantitative) were included. Five themes relating to resident wellbeing were identified in the qualitative evidence synthesis. These were animals as 'living beings', reminiscence and storytelling, caring (as 'doing' and 'feeling'), respite (from loneliness, institutionalisation, and illness), and sensory engagement. A sixth theme related to staff perceptions and wellbeing, and a seventh to animal health and wellbeing. Maintaining identity was identified as an overarching theme. The majority of randomised trials had small sample sizes and were rated as low quality, mostly showing no evidence of beneficial effect. There was, however, limited evidence of a positive effect of pet/animal interaction on outcomes of loneliness, anxiety and depression, supporting the themes of respite and sensory engagement. CONCLUSIONS The presence of animals can significantly impact the health and wellbeing of some care home residents. Residents had meaningful relationships with animals and derived pleasure and comfort from them. Interacting with animals offered residents a way to maintain a sense of self in the care homes, and with support, residents with dementia could also express their identities. Facilitating residents to interact with animals as part of person-centred care may also help residents to feel 'at home' in the care home. TRIAL REGISTRATION PROSPERO registration no: CRD42017058201.
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Affiliation(s)
- Noreen Orr
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK.
| | - Rebecca Abbott
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
| | - Alison Bethel
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
| | - Sarah Paviour
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Rebecca Whear
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
| | - Ruth Garside
- European Centre for Environment and Human Health, University of Exeter Medical School, Royal Cornwall Hospital, Knowledge Spa, Truro, Cornwall, TR1 3HD, UK
| | - Joanna Thompson Coon
- NIHR ARC South West Peninsula (PenARC), College of Medicine & Health, Evidence Synthesis Team, University of Exeter, South Cloisters, St. Luke's Campus, Exeter, EX1 2LU, Devon, UK
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17
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Sund M, Jaeger Fjetland K, Hanisch H. Within moments of becoming-everyday citizenship in nursing homes. Scand J Occup Ther 2023; 30:239-250. [PMID: 35758260 DOI: 10.1080/11038128.2022.2085621] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Humans are occupational beings. Our occupational choices depend on the opportunities available to us, and within nursing homes, institutional rules or structures may limit occupational engagement. An everyday citizenship lens acknowledges the importance of people's rights as citizens as well as engagement in mundane aspects of the everyday, highlighting diverse expressions of agency. AIMS/OBJECTIVES To show how older residents living with dementia in nursing homes can realize their everyday citizenship. METHODS A phenomenologically inspired ethnographic study was conducted in nursing home units in Norway, exploring everyday citizenship through narrative analysis. RESULTS Within everyday environments of care, the narratives of May, Janne and Camilla tell stories of spontaneous initiatives towards contribution and responsibilities, highlighting their continuous occupational natures. CONCLUSION Becoming can be seen as constitutive of self and identity, through residents' actions and contributions within the mundane and ordinary of everyday life, as an essential part of everyday citizenship. SIGNIFICANCE FOR PRACTICE A citizenship of becoming presupposes that institutional perceptions of activities being offered ought to be broadened towards supporting residents' natural desires to do and act within the mundane and ordinary of everyday life.
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Affiliation(s)
- Marianne Sund
- Centre of Diaconia and Professional Practice/Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | | | - Halvor Hanisch
- Faculty of Health Studies, VID Specialized University, Stavanger, Norway.,Work Research Institute, Oslo Metropolitan University, Oslo, Norway
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18
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Lai TWR, Raubenheimer J, du Toit SHJ. Intergenerational live-in student programmes for meaningful engagement: Creating cohesive and supportive collectives in aged-care facilities. Aust Occup Ther J 2023. [PMID: 36626851 DOI: 10.1111/1440-1630.12857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 10/27/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Older adults in residential aged-care facilities (RACFs) experience segregation from society and face limited opportunities to meaningfully engage on a social and/or occupational level due to various structural and systemic challenges. An occupational therapy-coordinated intergenerational live-in student programme (ILiSP) with allied health students was successfully pioneered across Sydney (Australia) to facilitate ongoing intergenerational contact. We explored how ongoing intergenerational contact influenced meaningful engagement of older adults in RACFs by investigating routinely collected clinical data and exploring stakeholders' perspectives. RESEARCH DESIGN AND METHODS We employed a concurrent nested mixed-methods design. Residents' attendance in weekly organisational activities and students' monthly volunteer hour reports were analysed to produce statistics for demonstrating the changes in residents' activity attendance alongside ongoing intergenerational contact. Qualitative data from discussions directed by the nominal group technique (NGT) with staff, management and students, individual interviews with relatives and residents, and narrative clinical documentation were thematically analysed. RESULTS The Wilcoxon signed-rank test indicated that residents' activity attendance increased during intergenerational contact. Qualitative data yielded three main themes-interdependence, meaningful engagement, and kinship-all associated with intergenerational contact as part of established ongoing relationships. The NGT highlighted consensus on on-site living for maintaining a cohesive and supportive collective. CONCLUSION Despite structural and systemic challenges within RACFs that dissuade community integration, ILiSP created opportunities for students to connect/reconnect residents to new/established networks and to support residents to maintain or re-engage with previous lifestyle preferences. Therefore, ongoing intergenerational contact fostered a cohesive collective in support of the social and occupational needs of residents, which should be capitalised on by policymakers (e.g., the National Aged Care Mandatory Quality Indicator Program) and interested organisations.
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Affiliation(s)
- Tsz Wang Rohan Lai
- Bachelor of Applied Science (Occupational Therapy) (Honours), Faculty of Medicine and Health (Discipline of Occupational Therapy), The University of Sydney, Camperdown, New South Wales, Australia
| | - Jacques Raubenheimer
- School of Medical Sciences, Biomedical Informatics and Digital Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sanetta Henrietta Johanna du Toit
- Faculty of Medicine and Health (Discipline of Occupational Therapy), The University of Sydney, Camperdown, New South Wales, Australia
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19
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Chen J, Gramegna SM, Biamonti A. A sense of home for people with dementia in a long-term care facility: A design perspective. Health Place 2023; 79:102957. [PMID: 36565539 DOI: 10.1016/j.healthplace.2022.102957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
The study aims to provide new insights into the approach to the spatial design of homelike dementia care facilities. This paper builds on Molony's (2010) findings that home meaning in care facilities is a process of people-place integration, and then proposes that people living with dementia can accomplish this process through their bodily habit. This research adopted an ethnographic case study approach. Three cases from a long-term care facility were studied by using semi-structured interviews and observations. According to the findings, having a sense of home for people living with dementia can be understood as a process of re-establishing people-place integration through their bodily habits in a long-term care facility. As a result, designers can consider which design features can assist people living with dementia in re-establishing this integration through bodily habit to create home feelings in a dementia care facility.
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Affiliation(s)
- Jing Chen
- LABIRINT Research Atelier, Department of Design, Politecnico di Milano, Milano, Italy.
| | - Silvia Maria Gramegna
- LABIRINT Research Atelier, Department of Design, Politecnico di Milano, Milano, Italy
| | - Alessandro Biamonti
- LABIRINT Research Atelier, Department of Design, Politecnico di Milano, Milano, Italy
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20
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Phlix M, Petermans A, Smetcoren AS, Vanrie J. The Happy Home: Ageing, Migration, and Housing in Relation to Older Migrants' Subjective Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:106. [PMID: 36612428 PMCID: PMC9819248 DOI: 10.3390/ijerph20010106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: With an increasingly diversifying ageing population, it is important to understand what 'ageing well' means to older adults with a migration background. Given older adults' preference to age in place and declining mobility, housing is a significant place in later life. Therefore, this paper explores the influence of housing, migration, and age on older migrants' subjective wellbeing, with attention to immaterial aspects such as a sense of home as well. (2) Methods: In-depth interviews with older migrants from various ethnicities (N = 22) were conducted. The data collection and analysis were led by an inductive and deductive approach through thematic analysis. (3) Results: The results point to the dynamic nature of age(ing) and the role of migration background in the subjective wellbeing of older migrants. The need for preserving one's housing situation and environmental mastery in later life is highlighted. Furthermore, the relation and mutual influence of subjective wellbeing and sense of home is uncovered. (4) Conclusions: This study highlights the intersection of age, migration, and housing to the subjective wellbeing and sense of home of older migrants. In addition, influences on older migrants' subjective wellbeing concern both a material (i.e., housing) and immaterial (i.e., sense of home, age, migration) base.
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Affiliation(s)
- Micheline Phlix
- Faculty of Architecture and Arts, UHasselt—Universiteit Hasselt, Agoralaan, 3590 Diepenbeek, Belgium
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Ann Petermans
- Faculty of Architecture and Arts, UHasselt—Universiteit Hasselt, Agoralaan, 3590 Diepenbeek, Belgium
| | - An-Sofie Smetcoren
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Jan Vanrie
- Faculty of Architecture and Arts, UHasselt—Universiteit Hasselt, Agoralaan, 3590 Diepenbeek, Belgium
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Matarese M, Mauro L, Notarnicola I, Cinque A, Bonacci S, Covelli G, Casciato S. Can we help older adults to feel at home in a residential care facility? What we can learn from health care personnel. JBI Evid Synth 2022; 20:2824-2825. [PMID: 36513381 DOI: 10.11124/jbies-22-00418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Maria Matarese
- Research Unit of Nursing Sciences, Department of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Lucia Mauro
- San Camillo-Forlanini Hospital of Rome, Rome, Italy
| | | | | | - Sara Bonacci
- Azienda Regionale Emergenza Sanitaria (ARES) 118, Rome, Italy
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22
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Moon S, Oh J, You SY. What information about choosing a nursing home is available on YouTube? Geriatr Nurs 2022; 48:320-326. [PMID: 36371879 DOI: 10.1016/j.gerinurse.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022]
Abstract
This study aimed to identify YouTube videos focused on choosing a nursing home. The contents of the videos were analyzed using 19 items from the guidelines proposed by the Donabedian model. An analysis of 57 videos showed that informal presentations for format (54.39%), laypersons for speaker (36.84%), and personal channel for uploader (61.40%) exhibited the highest frequency. According to the analysis of video content, most videos included the environment (49.12%), programs (38.63%), and cost (35.09%). However, fewer videos focused on care protocols (5.26%), participation (5.26%) and health outcomes (5.26%). More informal presentations, laypersons, and personal channels than health providers, professional groups, and mass media were included in videos focused on choosing nursing homes. It is necessary to provide information regarding the philosophy, care, and health outcomes of residents in addition to the information regarding environment and cost provided by reliable suppliers, such as health professionals, the government, and mass media.
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Affiliation(s)
- SeolHwa Moon
- Research Institute of Nursing Science, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Juyeon Oh
- College of Nursing, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31116, Republic of Korea
| | - Sun Young You
- Department of Nursing, Gangseo University, 47, Kkachisan-ro 24-gil, Gangseo-gu, Seoul, 07661, Republic of Korea.
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23
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Lev S, Dolberg P, Lang B. "They just did what they usually do": Mistreatment, abuse, and neglect in nursing homes from the perspective of Ministry of Health auditing teams. Geriatr Nurs 2022; 48:24-31. [PMID: 36099776 DOI: 10.1016/j.gerinurse.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 12/14/2022]
Abstract
The aim of this article was to examine how Ministry of Health auditing teams experience quality of care, mistreatment, abuse, and neglect in nursing homes in Israel. The research included four in-depth focus groups consisting of 19 multidisciplinary auditors. The qualitative analysis was encoded in stages with repeated comparisons between individual participants and within groups and led to three main themes: (1) Failure in addressing basic, personal, and social needs of residents in nursing homes; (2) Mistreatment manifested in violation of residents' privacy and human dignity, neglect, and physical harm; (3) Abuse, including psychological, financial, and physical abuse. The findings can be explained by the characteristics of nursing homes as total institutions, as well as perceptions of ageism and de-humanization of the residents. In addition, the findings highlight the importance of the auditing role in monitoring the nursing homes' quality of care and the safety of the residents.
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Affiliation(s)
- Sagit Lev
- School of Social Work, Bar-Ilan University, Israel.
| | - Pnina Dolberg
- Department of Social Work, Ruppin Academic Center, Israel
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24
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Wang Q, Zhang Y, Zhan H. Path towards home: Exploring pathways to the development of a sense of home in residential care settings in China. Australas J Ageing 2022; 42:80-89. [PMID: 36258656 DOI: 10.1111/ajag.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/06/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To understand different pathways leading to older adults' sense of home in residential care environments in China. METHODS This research adopted the qualitative comparative analysis method to analyse data from 29 interviews. Qualitative comparative analysis is an analytic strategy to systematically analyse potential causal pathways in small-to-medium-sized qualitative datasets. RESULTS Findings uncovered four different pathways that older adults followed in their process of constructing a sense of home in residential care environments in China. CONCLUSIONS This study adds to the body of literature by analysing how a sense of home in residential care environments can be achieved with pathways that contain a combination of sets of necessary, substitutive and absent conditions. It concludes that even though older adults may not live at home, they may achieve a sense of home by the joint effort at institutional, social and personal levels that facilitates older adults to find a sense of home.
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Affiliation(s)
- Qi Wang
- School of Law, Zhejiang University City College, Hangzhou, China
| | - Yunxiang Zhang
- College of Philosophy and Political Science, Shanghai Normal University, Shanghai, China
| | - Heying Zhan
- Department of Sociology, Georgia State University, Atlanta, Georgia, USA
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25
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Xiao LD, Gregoric C, Gordon S, Ullah S, Goodwin-Smith I, Muir-Cochrane E, Blunt S. Staff perceived challenges and facilitators in supporting resident self-determination in ethno-specific and mainstream nursing homes. J Clin Nurs 2022. [PMID: 35799405 DOI: 10.1111/jocn.16440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/10/2022] [Accepted: 06/23/2022] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To explore and compare staff perceived challenges and facilitators in supporting resident self-determination in ethno-specific and mainstream nursing homes. BACKGROUND Staff and residents in ethno-specific and mainstream nursing homes in most developed countries have shown increased cultural and linguistic diversity. This socio-demographic change poses significant challenges for staff to support resident self-determination of their own care. In-depth understanding of those challenges in the two types of nursing homes is much needed to inform practice in nurse-led nursing home care settings. METHOD A qualitative description approach with thematic analysis was used in the study. Data were collected through five focus groups with 29 various direct care workers from two ethno-specific nursing homes and a mainstream nursing home in Australia between March-September 2020. The study report followed the COREQ checklist. RESULTS Four themes were identified from focus group data. First, participants perceived communication challenges in identifying residents' preferences, especially in ethno-specific nursing homes. Second, team efforts that included residents and their family members were highly valued as a way to meet residents' preferences. Third, participants described various levels of staff engagement in residents' care planning. In addition, staff in ethno-specific nursing homes possessed richer resources to maintain meaningful relationships for residents compared with their counterparts in the mainstream nursing home. CONCLUSIONS Staff in ethno-specific nursing homes experience more challenges in supporting resident self-determination but have richer resources to develop culturally safe and culturally competent care compared with their counterparts in the mainstream nursing home. RELEVANCE TO CLINICAL PRACTICE Findings provide new insights into challenges and practical solutions in supporting residents to self-determine their own care in cross-cultural aged care. PATIENT OR PUBLIC CONTRIBUTION This study was co-designed with three aged care organisations who funded the study. Staff employed by these organisations participated in the study.
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Affiliation(s)
- Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Carolyn Gregoric
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sue Gordon
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Ian Goodwin-Smith
- College of Business, Government & Law, Flinders University, Flinders University, Adelaide, South Australia, Australia
| | - Eimear Muir-Cochrane
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sara Blunt
- Kalyra Communities (an aged care organisation), Adelaide, South Australia, Australia
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26
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Wahlroos N, Narsakka N, Stolt M, Suhonen R. Physical Environment Maintaining Independence and Self-management of Older People in Long-Term Care Settings—An Integrative Literature Review. JOURNAL OF AGING AND ENVIRONMENT 2022. [DOI: 10.1080/26892618.2022.2092927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Niina Wahlroos
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Noora Narsakka
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Welfare Services Division, Department of Nursing Science, Turku University Hospital and City of Turku, University of Turku, Turku, Finland
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Debesay J, Arora S, Fougner M. Organisational culture and ethnic diversity in nursing homes: a qualitative study of healthcare workers' and ward nurses' experiences. BMC Health Serv Res 2022; 22:843. [PMID: 35773681 PMCID: PMC9248104 DOI: 10.1186/s12913-022-08184-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background The increase in care needs that comes with an ageing population, in combination with a shortage of healthcare workers, has made ethnic diversity among healthcare workers (HCW) an evident reality across many countries. This article aims to explore how a multicultural workplace is experienced, through the accounts of HCWs and leaders in nursing homes. Methods This article reports on the findings from qualitative interviews with 16 HCWs and managers from nursing homes in Oslo. The interviews were conducted from August to September 2021. We analysed the data using a reflective thematic analysis informed by a hermeneutic-phenomenological approach. Results Six themes emerged from the interview data: (1) understanding diversity through shared norms and multicultural experiences, (2) greater flexibility in a multicultural workforce, (3) challenging traditional norms in a multicultural workforce, (4) language proficiency and exclusionary practices at work, (5) perceptions of the role of the ward nurse, and (6) prejudices among and harassment from patients. Conclusions To ensure the effective organisation and wellbeing of HCWs in a multicultural workforce, managers must develop an inclusive organisational culture. They must be able to engage with difficult topics and conflicts that may arise in the working environment.
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Affiliation(s)
- Jonas Debesay
- Faculty of Health, Department of Nursing, Oslo Metropolitan University, PO box 4 St. Olavs plass, NO-0130, Oslo, Norway.
| | - Sanjana Arora
- Faculty of Science and Technology, Department of Safety, Economics and Planning, University of Stavanger, PO box 8600, 4036, Stavanger, Norway
| | - Marit Fougner
- Faculty of Health, Department of Physiotherapy, Oslo Metropolitan University, PO box 4 St. Olavs plass, NO-0130, Oslo, Norway
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Melchiorre MG, D’Amen B, Quattrini S, Lamura G, Socci M. Caring for Frail Older People Living Alone in Italy: Future Housing Solutions and Responsibilities of Family and Public Services, a Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127413. [PMID: 35742664 PMCID: PMC9223601 DOI: 10.3390/ijerph19127413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/20/2022]
Abstract
When frail older people age alone in place, with increasing functional limitations, they require support in performing daily living activities. In this respect, it is important to assess their preferences in terms of future housing solutions, and their opinions/orientations on the care responsibilities of both family and public services. The present study aimed to explore these aspects in Italy. Qualitative interviews were carried out in 2019 within the “Inclusive ageing in place” (IN-AGE) research project, involving 120 frail older people who lived at home in three Italian regions (Lombardy, Marche, and Calabria). A content analysis was conducted, and some quantifications of interviewees’ statements were provided. The results revealed that the majority of seniors prefer ageing at home, at least with a personal care assistant (PCA), whereas moving to a nursing home is typically deemed as a last option. Moreover, they considered the family to be primarily responsible for taking care of them, even with the support of public services. In addition, some territorial differences emerged. Strengthening an integrated model of long-term care (LTC) for older people, where both formal and informal supports allow frail older people to age at home, seems thus a good overall policy solution to pursue, with interventions based also on the needs and preferences of both seniors and their respective families.
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Developing a Meaningful Garden Space in a Care Home with Staff and Family Members: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127025. [PMID: 35742271 PMCID: PMC9222630 DOI: 10.3390/ijerph19127025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023]
Abstract
Background: Care home residents are often passive and lack active engagement in meaningful activities. The aim of this qualitative study was to co-develop a plan for a meaningful garden space in an urban care home in the north of England, to inform the subsequent building of such a garden space on the care home premises. Methods: Members of staff participated in focus groups conducted at the care home. Family carers were interviewed by telephone. Both focus groups and interviews were audio-recorded, with transcripts analysed independently using thematic analysis by two researchers, and consensus achieved on final themes. Findings: Two focus groups with staff (n = 17) and seven interviews with family carers were held. Thematic analysis generated seven key themes for the garden about its meaning and environmental features: (1) Current opinions on physical environment; (2) access; (3) adaptation to the environment; (4) staffing; (5) socialising; (6) sensory features; and (7) active meaningful participation. The garden needed to be accessible to residents in wheelchairs, and in all weathers and seasonal conditions, as well as being adapted to the needs of people living with dementia. Areas for social activities, such as picnics, and intergenerational activities, as well as private spaces, were recommended. Throughout the garden, sensory features were suggested, incorporating the use of vision, smell, touch, and sound, such as through water features. Moreover, it was recommended that residents should be able to contribute to the delivery of the activities themselves, including through a café and a vegetable garden. Conclusions: Family carers and staff considered that the garden would benefit from an intensive update to meet the needs of residents. This study therefore has practical implications for care home design, which are of even greater importance since the pandemic, as outdoor spaces were considered safer for care home visiting.
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Implementation of a Sense of Home in High-Density Multicultural Singapore Nursing Homes: Challenges and Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116557. [PMID: 35682141 PMCID: PMC9180143 DOI: 10.3390/ijerph19116557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Abstract
Many studies have introduced principles for creating a sense of home in nursing homes, yet they mostly feature cases from low-density developments in Western countries. This raises a question about how those principles are interpreted and implemented in other cultural contexts, especially in high-density, multicultural environments such as Singapore. This paper examines how a sense of home is implemented in Singapore nursing homes, with a specific focus on the role of the built environment. Participant observations were conducted in five nursing homes in Singapore comprising various architectural design typologies, with the focus on the residents’ everyday interactions with their built environment. The study identified the extent of the presence of a sense of home in Singapore’s nursing homes and the prevalence of an institutional care model. More specifically, the study explicates Singapore nursing home residents’ management of privacy and personalization in shared spaces, illuminates the need for holistic implementation of homelike environments integrated with building designs and care programs and reiterates the pivotal role of social relationships in fostering a sense of home for the residents in the nursing homes.
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31
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Strong JV, Plys E, Hinrichs KLM, Hartmann CW, McCullough M. Music for your mental health? The development and evaluation of a group mental health intervention in subacute rehabilitation. Aging Ment Health 2022; 26:950-957. [PMID: 34121525 DOI: 10.1080/13607863.2021.1935463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Short-stay residents of nursing homes experience high rates of mental health (MH) distress compared to community dwelling counterparts, yet MH interventions are difficult to implement and sustain. We modified a music therapy framework to Effective Music in Psychotherapy. Using the modified model, we integrated music listening into MH group intervention and evaluated MH outcomes. This pilot study reports the development and evaluation of the Mental Health and Music Group for short-stay nursing homes residents.Method: The group was developed and refined to be non-sequential and non-cumulative, specific to the needs of short-stay nursing home residents. Pre-/post-session ratings examined affect, quality of life, and pain. Leaders monitored engagement across and between sessions. Qualitative interviews were conducted with a selection of attendees.Results: Findings indicated decreases in irritation and worry, and increases in mood, energy, and self-as-a-whole from pre- to post-session. There were no changes in pain, perception of physical health or life-as-a-whole, energetic, sad, or happy affect, or differences in engagement. Qualitative interviews demonstrated benefits of group modality and music to group cohesion and highlighted the relevance of music for mental health outcomes.Conclusion: The Mental Health and Music group was designed around a framework of Effective Music in Psychotherapy, for short-stay nursing home settings, and demonstrated promising results. Future research can solidify the interventions generalizeability to medical and rehabilitation settings addressing the specific population needs and preferences.Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2021.1935463 .
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Affiliation(s)
- Jessica V Strong
- VA Boston Healthcare System, Boston, MA, USA.,New England Geriatric Research Education and Clinical Center, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Department of Psychology, Faculty of Arts, University of Prince Edward Island, Charlottetown, Canada
| | - Evan Plys
- VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kate L M Hinrichs
- VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Christine W Hartmann
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System.,Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Megan McCullough
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System.,Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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O’Neill M, Ryan A, Tracey A, Laird L. 'The Primacy of 'Home': An exploration of how older adults' transition to life in a care home towards the end of the first year. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e478-e492. [PMID: 33242367 PMCID: PMC9292794 DOI: 10.1111/hsc.13232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/18/2020] [Accepted: 10/20/2020] [Indexed: 05/12/2023]
Abstract
This grounded theory study sought to explore how older adults' experience the transition from living at home to a care home with a specific focus on the latter part of the first year of the move. The study was carried out within a large Health Trust in the UK between August 2017 and May 2019. Purposive sampling was used in the initial stages of data collection. Thereafter and consistent with grounded theory methodology, theoretical sampling was employed to undertake semi-structured interviews with 17 individuals from eight care homes between 5 and 12 months after the move. This paper reports five key categories which were: (a) The lasting effect of first Impressions 'They helped me make my mind up' (b) On a Journey 'I just take it one day at a time', (c) Staying connected and feeling 'at home' 'You get something good out of it you know…you get hope'. (d) Managing loss and grief 'It was important for me to say cheerio to the house' and (e) Caring relationships 'I didn't realise that I was lonely until I had company'. Together these five categories formed the basis of the core category 'The Primacy of 'Home' which participants identified as a place they would like to feel valued, nurtured and have a sense of belonging. This study identifies that it is important for individual preferences and expectations to be managed from the outset of the move. Individuals and families need to be supported to have honest and caring conversations to promote acceptance and adaptation to living in a care home while continuing to embrace the heart of 'home'. Key recommendations from this study include the need to raise awareness of the significance of the ongoing psychological and emotional well-being needs of older people which should be considered in policy directives and clinical practice.
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Affiliation(s)
- Marie O’Neill
- School of Nursing and Institute of Nursing and Health ResearchUlster UniversityCo LondonderryNorthern Ireland
| | - Assumpta Ryan
- School of Nursing and Institute of Nursing and Health ResearchUlster UniversityCo LondonderryNorthern Ireland
| | - Anne Tracey
- School of PsychologyUlster UniversityColeraine, Co LondonderryNorthern Ireland
| | - Liz Laird
- School of Nursing and Institute of Nursing and Health ResearchUlster UniversityCo LondonderryNorthern Ireland
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Lynn JD, Ryan A, McCormack B, Martin S. A Qualitative Exploration of Living with Dementia in Supported Living Environments using a Peer Researcher Approach. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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The Connections between Attitudes towards Nursing Home Placement, Intergenerational Solidarity, and the Conflict between Tradition and Modernity among Three Generations of Arab Muslim Families in Israel. J Aging Res 2021; 2021:6148980. [PMID: 34471547 PMCID: PMC8405315 DOI: 10.1155/2021/6148980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/18/2021] [Accepted: 08/10/2021] [Indexed: 11/17/2022] Open
Abstract
The goal of this study was to examine three generations of Arab Muslims in Israel, to investigate the relationships between their attitudes regarding the placement of an older relative in a nursing home, intergenerational solidarity, and to ultimately proceed with the nursing home placement. The backdrop to this examination was the increasing sociocultural tension between modernization tendencies and the long-established traditions and norms in the Arab Muslim society in Israel. The sample included a total of 126 university students, as well as one parent and one grandparent of each student. All participants completed identical questionnaires examining the attitudes towards the nursing home placement of an elder relative. The findings of the study indicate a strong objection among the youngest generation, whose attitudes were more similar to those of their grandparents than to those of their parents. Psychosocial mechanisms in the Arab Muslim population, such as intergenerational solidarity, has been the subject of increased scrutiny and debate over recent years, given the intensive pace of modern developments, which has called into question the familiar norms, thus constituting a threat to the tradition that has guided the population throughout numerous centuries and generations.
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A conceptual analysis of the meaning of comfort at the end-of-life using the Walker and Avant (2014) Framework. FRONTIERS OF NURSING 2021. [DOI: 10.2478/fon-2021-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
The aim of the authors is to clarify the concept of comfort at the end-of-life in order to support understandings of fundamental nursing care needed at this stage of healthcare.
Methods
The Walker and Avant framework was applied to develop a deeper understanding of the concept of comfort at the end of life.
Results
Five defining attributes of comfort in the end-of-life were identified and they are having a peaceful home-life environment, trust and consolation, proximity and social-cultural support, alleviation of suffering, and a process of integrated intervention by nurses.
Conclusions
At the end-of-life patients commonly experience physical, psychological, social-cultural, and environmental discomfort. Patients’ families also encounter significant challenges. However, their comfort needs are often secondary to that of the patient. Additionally, a lack of clarity exists regarding the holistic meaning of comfort at the end-of-life, which can largely be confined to understandings of physical comfort for the patient, with a limited understanding of addressing family/caregivers’ needs. Therefore, this concept analysis may provide some guidance in this regard and also provides support toward a more integrated understanding of the concept.
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Travers JL, Hirschman KB, Naylor MD. Older Adults' Goals and Expectations When Using Long-Term Services and Supports. J Appl Gerontol 2021; 41:709-717. [PMID: 34315240 DOI: 10.1177/07334648211033671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Despite recent research focused on aging well, little is known regarding the goals and expectations from long-term services and supports (LTSS) use among older adults. METHODS To address this knowledge gap, interviewer-guided surveys with older adults newly receiving LTSS in home and community-based, assisted living, and nursing home settings in Philadelphia, New Jersey, and New York were conducted. RESULTS Twelve subthemes regarding the goals and expectations of 464 older adults receiving LTSS and in the context of Aging Well emerged from our analysis: maintaining function, optimizing health and circumstances, maintaining the status quo, transitioning back to the previous state, achieving independence, preserving cognitive function and capacity for psychosocial and emotional health, achieving purpose, increasing quality of life, receiving social support, increasing engagement, relieving burden, and feeling a sense of security/safety. DISCUSSION This in-depth analysis of qualitative data provides context for LTSS use among older adults.
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Affiliation(s)
| | | | - Mary D Naylor
- University of Pennsylvania School of Nursing, Philadelphia, USA
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37
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‘Knowing me, knowing you’: an exploration of the views and experiences of nursing home residents and staff on their nursing home as ‘home’. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The overall aim of this grounded theory study was to explore the context of a nursing home as ‘home’ from the perspective of residents and staff. Sixteen focus group interviews were used to collect qualitative data from nursing home residents (N = 48) and staff (N = 44). Five distinct categories captured the views and experiences of participating residents and staff. These were: (a) Starting off on the right foot, ‘First impressions can be the lasting ones; (b) Making new and maintaining existing connections, ‘There is great unity between staff and residents’; (c) The nursing home as home, ‘It's a bit like home from home for me’; (d) Intuitive knowing, ‘I don't even have to speak, she just knows’; and (e) Feeling at home in a regulated environment, ‘It takes the home away from nursing home’. Together these five categories formed the basis of the core category ‘Knowing me, knowing you’, which captures the experiences of participants who repeatedly highlighted the importance of relationships and feelings of mutuality and respect between and among staff and residents as central to feeling at home in a nursing home. The reciprocity and mutuality associated with the core category, ‘Knowing me, knowing you’, was at times challenged by staff shortages, time constraints, and conflicting priorities associated with the co-existence of a regulated and homely environment.
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Healthcare personnel experiences implementing carbapenem-resistant Enterobacterales infection control measures at a ventilator-capable skilled nursing facility-A qualitative analysis. Infect Control Hosp Epidemiol 2021; 43:1010-1016. [PMID: 34154697 DOI: 10.1017/ice.2021.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Ventilator-capable skilled nursing facilities (vSNFs) are critical to the epidemiology and control of antibiotic-resistant organisms. During an infection prevention intervention to control carbapenem-resistant Enterobacterales (CRE), we conducted a qualitative study to characterize vSNF healthcare personnel beliefs and experiences regarding infection control measures. DESIGN A qualitative study involving semistructured interviews. SETTING One vSNF in the Chicago, Illinois, metropolitan region. PARTICIPANTS The study included 17 healthcare personnel representing management, nursing, and nursing assistants. METHODS We used face-to-face, semistructured interviews to measure healthcare personnel experiences with infection control measures at the midpoint of a 2-year quality improvement project. RESULTS Healthcare personnel characterized their facility as a home-like environment, yet they recognized that it is a setting where germs were 'invisible' and potentially 'threatening.' Healthcare personnel described elaborate self-protection measures to avoid acquisition or transfer of germs to their own household. Healthcare personnel were motivated to implement infection control measures to protect residents, but many identified structural barriers such as understaffing and time constraints, and some reported persistent preference for soap and water. CONCLUSIONS Healthcare personnel in vSNFs, from management to frontline staff, understood germ theory and the significance of multidrug-resistant organism transmission. However, their ability to implement infection control measures was hampered by resource limitations and mixed beliefs regarding the effectiveness of infection control measures. Self-protection from acquiring multidrug-resistant organisms was a strong motivator for healthcare personnel both outside and inside the workplace, and it could explain variation in adherence to infection control measures such as a higher hand hygiene adherence after resident care than before resident care.
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Cater D, Tunalilar O, White DL, Hasworth S, Winfree J. “ Home is Home:” Exploring the Meaning of Home across Long-Term Care Settings. JOURNAL OF AGING AND ENVIRONMENT 2021. [DOI: 10.1080/26892618.2021.1932012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Diana Cater
- Institute on Aging, College of Urban and Public Affairs, Portland State University, Portland, Oregon, USA
| | - Ozcan Tunalilar
- Institute on Aging, College of Urban and Public Affairs, Portland State University, Portland, Oregon, USA
- Nohad A. Toulan School of Urban Studies and Planning, Portland State University, Portland, Oregon, USA
| | - Diana L. White
- Institute on Aging, College of Urban and Public Affairs, Portland State University, Portland, Oregon, USA
| | - Serena Hasworth
- Institute on Aging, College of Urban and Public Affairs, Portland State University, Portland, Oregon, USA
| | - Jaclyn Winfree
- Institute on Aging, College of Urban and Public Affairs, Portland State University, Portland, Oregon, USA
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Wahlroos N, Stolt M, Nordin S, Suhonen R. Evaluating physical environments for older people-Validation of the Swedish version of the Sheffield Care Environment Assessment Matrix for use in Finnish long-term care. Int J Older People Nurs 2021; 16:e12383. [PMID: 34029003 DOI: 10.1111/opn.12383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/01/2020] [Accepted: 04/30/2021] [Indexed: 01/16/2023]
Abstract
AIM To validate a Finnish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM) instrument for assessing the physical environment of long-term care settings and to describe the current status of the environmental quality of long-term care settings for older people in Finland. BACKGROUND The importance of providing a well-designed physical environment for older people is supported by the research literature. There is limited research of the physical environments of long-term care settings from the perspective of nursing science and nor is there much research into the instruments for assessing them. DESIGN A descriptive, correlational and observational study. METHODS Forward and back translation process was used followed by structured observations with S-SCEAM-Fin in 20 long-term care units in intensive residential care facilities for older people with 24-h nursing assistance and with extensive support for daily activities. Spearman's rho correlation, Cohen's kappa, percentage of agreement and Kuder-Richardson formula coefficients were calculated to assess psychometric properties of the translated S-SCEAM-Fin. S-SCEAM-Fin standardised scores were calculated to describe the current status of the environmental quality. RESULTS Inter-scale (domain) correlations showed low to moderate correlations between the domains. Consistency was acceptable in four of the domains. Cohen's kappa values indicated good (0.796 and 0.648) intra-rater and inter-rater (0.910 and 0.553) reliability. The overall mean of the standardised scores was 57.00, but there was variation between domains. Small units received the highest scores in the six domains. CONCLUSIONS S-SCEAM-Fin was useful in assessing environmental quality. Assessment of the environmental quality disclosed deficiencies in ensuring settings adequate for older people. IMPLICATIONS FOR PRACTICE The increasing numbers of older people with health conditions are residing in long-term care settings. It is essential to create supportive physical environments. The instrument can be useful when planning new facilities or proposing new recommendations for institutional living environments.
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Affiliation(s)
- Niina Wahlroos
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Susanna Nordin
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital and City of Turku, Welfare Division, Turku, Finland
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Tinelli M, Tiseo G, Falcone M. Prevention of the spread of multidrug-resistant organisms in nursing homes. Aging Clin Exp Res 2021; 33:679-687. [PMID: 33428170 DOI: 10.1007/s40520-020-01746-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 10/22/2020] [Indexed: 01/17/2023]
Abstract
The increase in the aged population led to a global rise in the demand for elderly healthcare services, such as long-term care facilities (LTCFs), nursing homes, residential homes. Unfortunately, the spread of multidrug-resistant organisms (MDROs) in these structures represent an urgent public health threat requiring immediate action. The aim of this review is to provide a practice guide for the prevention of infections in European LTCFs. A team of experts identify specific problems and proposed practical solutions for the management of colonized and infected patients residing in LTCFs. The heterogeneity of LTCF represents one of the main problems for the implementation of standardized surveillance and infection control programs. Crucial steps involved in the spread of infections among LTCF residents are represented by patient's accommodation, MDRO screening on admission, management of patients with rectal colonization by MDROs, management of patients at high risk of MDRO infections, MDRO transmission by staff and implementation of antimicrobial stewardship. Efforts to implement specific actions in each of these fields are required to reduce the infections in this setting.
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Affiliation(s)
- M Tinelli
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy.
| | - G Tiseo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Falcone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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42
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Helgesen AK, Larsen DW, Grøndahl VA. Quality of Care in a Nursing Home as Experienced by Patients with Dementia. J Multidiscip Healthc 2020; 13:1947-1955. [PMID: 33364776 PMCID: PMC7751599 DOI: 10.2147/jmdh.s285668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/11/2020] [Indexed: 01/10/2023] Open
Abstract
Background Dementia care is one of the most rapidly growing areas in health care. Despite this, relatively little is known about the experiences of persons with dementia in relation to quality of care. Objective The aim of this study was to describe how persons with dementia in nursing homes experience the quality of care. Design A cross-sectional design was used. Setting and Participants The study was conducted in a nursing home in Norway. A total of 33 persons with dementia participated. Results Respondents’ mean age was 86.7 years. More than 80% reported their health as bad/neither good nor bad. Concerning their satisfaction with staying in the nursing home, two in ten were satisfied. Nearly half answered that they received or sometimes received good help and support when anxious. More than 50% reported that they only sometimes received or never received good help and support when they felt lonely. The majority perceived that the nurses came/or sometimes came when needed (79%) and that the nurses had time/sometimes had time to talk with them (73%). Conclusion This study reveals that the voice of persons with dementia must be listened to, in order to increase the quality of care in nursing homes. The challenge concerning how living in nursing homes can be more satisfying must be addressed by leaders and nurses in nursing homes, as well as researchers. Special attention must be paid to anxiety, loneliness, and going outdoors.
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Affiliation(s)
- Ann Karin Helgesen
- Faculty of Health and Welfare Sciences, Østfold University College, Halden, Norway
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43
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Horstmanshof L, Garbutt R, Brownie S. Older adults who move to independent living units: A regional Australian study. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Louise Horstmanshof
- School of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia,
| | - Rob Garbutt
- School of Arts and Social Sciences, Southern Cross University, Lismore, New South Wales, Australia,
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Sánchez-González D, Rojo-Pérez F, Rodríguez-Rodríguez V, Fernández-Mayoralas G. Environmental and Psychosocial Interventions in Age-Friendly Communities and Active Ageing: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8305. [PMID: 33182710 PMCID: PMC7696667 DOI: 10.3390/ijerph17228305] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 01/04/2023]
Abstract
Background: The academic literature contains little information regarding the interventions that create age-friendly cities and communities in order to promote active ageing. Objectives: A systematic review was carried out to determine the available empirical evidence in relation to the characteristics, content and effectiveness of interventions aimed at improving environmental and psychosocial risk factors for older people, from the perspective of age-friendly communities and the promotion of active ageing. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the studies retained in this review were identified through a systematic search of the academic literature in selected electronic databases including Web of Science and Scopus. Independent critical appraisal and data extraction were conducted by two reviewers. The checklist was used to assess the quality of the articles. Findings: The search identified 1020 potentially eligible documents, of which 11 satisfied the established criteria. Non-exhaustive practices prevailed over rigorous investigations, with a high proportion of studies observed to be of low methodological quality and at high risk of bias. This reflected the predominance of uncontrolled interventions. Environmental interventions were focused on reducing risk and adapting the everyday environmental setting, while psychosocial interventions prioritised social strategies (behavioural changes, promotion of participation) and training. Interventions were more effective in certain domains of age-friendly cities and communities such as transportation and housing, followed by increased participation as a lifestyle-related behavioural change. The inferred changes were associated with providing information and enhancing skills; modifying access, barriers, exposures, and opportunities; enhancing services and support; continuity and effectiveness of changes over time; and modifying policies based on the bottom-up approach of age-friendly cities and communities (AFCC). Discussion and conclusion: Interventions focused on personal and organisational aspects might have positive effects in the longer term. However, fewer changes would be observed in interventions revolving around changing lifestyles owing to the impact of complex multi-causal factors. The relative effectiveness in terms of health calls into question the design of interventions and the supposed "friendliness" of certain communities. There is a need to encourage sound longitudinal research aimed at providing key knowledge for the implementation and evaluation of public policies, and to encourage age-friendly community programmes to promote active ageing.
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Affiliation(s)
- Diego Sánchez-González
- Department of Geography, National Distance Education University (UNED), 28040 Madrid, Spain
| | - Fermina Rojo-Pérez
- Research Group on Ageing (GIE-CSIC), Institute of Economics, Geography and Demography (IEGD), Spanish National Research Council (CSIC), 28037 Madrid, Spain; (F.R.-P.); (V.R.-R.); (G.F.-M.)
- Ageing Network of the Latin American Population Association (ALAP), Rio de Janeiro, Brazil
| | - Vicente Rodríguez-Rodríguez
- Research Group on Ageing (GIE-CSIC), Institute of Economics, Geography and Demography (IEGD), Spanish National Research Council (CSIC), 28037 Madrid, Spain; (F.R.-P.); (V.R.-R.); (G.F.-M.)
- Ageing Network of the Latin American Population Association (ALAP), Rio de Janeiro, Brazil
| | - Gloria Fernández-Mayoralas
- Research Group on Ageing (GIE-CSIC), Institute of Economics, Geography and Demography (IEGD), Spanish National Research Council (CSIC), 28037 Madrid, Spain; (F.R.-P.); (V.R.-R.); (G.F.-M.)
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45
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Anderson DC, Grey T, Kennelly S, O'Neill D. Nursing Home Design and COVID-19: Balancing Infection Control, Quality of Life, and Resilience. J Am Med Dir Assoc 2020; 21:1519-1524. [PMID: 33138934 PMCID: PMC7603995 DOI: 10.1016/j.jamda.2020.09.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 02/04/2023]
Abstract
Many nursing home design models can have a negative impact on older people and these flaws have been compounded by Coronavirus Disease 2019 and related infection control failures. This article proposes that there is now an urgent need to examine these architectural design models and provide alternative and holistic models that balance infection control and quality of life at multiple spatial scales in existing and proposed settings. Moreover, this article argues that there is a convergence on many fronts between these issues and that certain design models and approaches that improve quality of life, will also benefit infection control, support greater resilience, and in turn improve overall pandemic preparedness.
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Affiliation(s)
- Diana C Anderson
- Division of Geriatrics, University of California, San Francisco, CA, USA.
| | - Thomas Grey
- TrinityHaus Research Centre, Trinity College, Dublin, Ireland
| | - Sean Kennelly
- Centre for Aging, Neuroscience and the Humanities, Trinity College, Dublin, Ireland
| | - Desmond O'Neill
- Centre for Aging, Neuroscience and the Humanities, Trinity College, Dublin, Ireland
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46
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What kind of home is your care home? A typology of personalised care provided in residential and nursing homes. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20001142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
This paper examines how care home managers in England conceptualised the approach to delivering personalised care in the homes they managed. We conducted interviews with care home managers and mapped the approaches they described on two distinct characterisations of personalised care prominent in the research and practitioner literature: the importance of close care relationships and the degree of resident choice and decision-making promoted by the care home. We derived three ‘types’ of personalised care in care homes. These conceptualise the care home as an ‘institution’, a ‘family’ and a ‘hotel’. We have added a fourth type, the ‘co-operative’, to propose a type that merges proximate care relationships with an emphasis on resident choice and decision-making. We conclude that each approach involves trade-offs and that the ‘family’ model may be more suitable for people with advanced dementia, given its emphasis on relationships. While the presence of a range of diverse approaches to personalising care in a care home market may be desirable as a matter of choice, access to care homes in England is likely to be constrained by availability and cost.
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47
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Yong B, Lin R, Xiao H. Factors associated with nursing home adjustment in older adults: A systematic review. Int J Nurs Stud 2020; 113:103790. [PMID: 33161332 DOI: 10.1016/j.ijnurstu.2020.103790] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND An ageing population has resulted in increased numbers of older adults moving to a nursing home, and the challenges triggered by relocation are highlighted. Various factors are identified to be associated with relocation and psychological adjustment to living in a nursing home. However, no systematic review has synthesised the evidence, and its associated factors remain unclear. OBJECTIVE To examine and synthesise the best available evidence on the factors associated with adjustment to living in a care facility. DESIGN Systematic review. DATA SOURCES Nine electronic databases were searched from database inception to March 2020: Pubmed, Embase, CINAHL, PsycINFO, Cochrane library, China National Knowledge Infrastructure, China Wanfang Database, Chinese Biomedical Literature Database, Chinese Periodical Full-text Database. REVIEW METHODS The references listed in the included studies were manually checked. The quality of the eligible studies was assessed using the 11-item checklist of the Agency for Healthcare Research and Quality. RESULTS A total of 20 studies were included in this review, with 17 cross-sectional studies, and three longitudinal study. 19 studies were rated as moderate quality and the other one was high quality. 17 measures were used to assess nursing home adjustment. Six distinct categories of the associated factors for nursing home adjustment were identified: demographic characteristics (n = 11), physiological factors (n = 3), psychological factors (n = 9), social factors (n = 9), relocation factors (n = 6), and facility factors (n = 5). CONCLUSIONS Decision-making control, self-efficacy, social support, activities of daily living, and length of stay should all be taken into account when assisting resident scoping with a relocation to a nursing home. Infuture research, multiple areas can be considered when improving the level of nursing home adjustment, as well as interventions and health policies. REGISTRATION NUMBER PROSPERO CRD 42018115935. TWEETABLE ABSTRACT A systematic review of the factors associated with adjustment to living in a care facility.
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Affiliation(s)
- Binbin Yong
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rongjin Lin
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, NO 1 Xuefu North Road, University Town, Shangjie Zhen, Minhou County, Fuzhou City, Fujian Province, China.
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48
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Weaver RH, Roberto KA, Brossoie N. A Scoping Review: Characteristics and Outcomes of Residents Who Experience Involuntary Relocation. THE GERONTOLOGIST 2020; 60:e20-e37. [PMID: 31112600 DOI: 10.1093/geront/gnz035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Relocation to a residential care facility has been described as the most significant relocation affecting older adults, yet subsequent relocations, like in the case of a facility closure, have received minimal attention in the scholarly research literature. This paper reviews the published literature on involuntary relocation, focusing on the experiences of residents, families, and staff and the effects of involuntary relocation on nursing home residents' health. RESEARCH DESIGN AND METHODS We conducted a scoping review to identify peer-reviewed studies reporting on involuntary relocation of nursing home residents. A total of 28 quantitative, qualitative, and mixed-method articles met inclusion criteria. RESULTS Researchers mostly relied on longitudinal designs and quantitative indicators of functional health, cognitive status, psychological and emotional well-being, environment, and relocation context to examine residents' mortality risk and health outcomes associated with involuntary relocation. Inclusion of qualitative and mixed-method approaches was infrequent, as were indicators of social engagement and perceptions of relocation. Residents' awareness of and preparation for involuntary relocation positively influenced their health and well-being. Family involvement was frequently hindered by communication challenges with facilities. Staff expressed concern about residents, experienced increased workload demands, and acknowledged challenges with planning and communication. DISCUSSION AND IMPLICATIONS Based on the collective findings, we propose a conceptual model of critical factors at play during relocation for consideration for guiding future research and developing provisions to current policies guiding relocation processes. Facilities and policymakers need to consider procedures that enhance planning efforts and decision-making among this vulnerable population and their families.
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Affiliation(s)
- Raven H Weaver
- Department of Human Development, Washington State University, Pullman
| | - Karen A Roberto
- Institute for Society, Culture and Environment.,Center for Gerontology, Virginia Tech, Blacksburg
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Hämel K, Röhnsch G. Between Social Inclusion and Exclusion: Integration of Daycare Guests in the Nursing Home Setting. THE GERONTOLOGIST 2020; 61:1030-1040. [PMID: 33034645 PMCID: PMC8437502 DOI: 10.1093/geront/gnaa157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.
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Affiliation(s)
- Kerstin Hämel
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Gundula Röhnsch
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Bielefeld, Germany
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50
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Arora S, Straiton M, Bergland A, Rechel B, Debesay J. Renegotiating formal and informal care while ageing abroad: Older Pakistani women's healthcare access, preferences and expectations in Norway. J Migr Health 2020; 1-2:100002. [PMID: 34405158 PMCID: PMC8352009 DOI: 10.1016/j.jmh.2020.100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/02/2020] [Accepted: 09/24/2020] [Indexed: 12/01/2022] Open
Abstract
This study explores older Pakistani women's preferences and expectations of formal and informal care while ageing in Norway. Our study is based on qualitative interviews with older Pakistani women living in Oslo municipality, Norway. The participants were aged between 48 and 81 years and had been living in Norway for 26 to 46 years. Our analyses resulted in five themes: 1) renegotiating the expectations of informal care in light of the 'nazaam' (or social system and practices) of Norway, 2) fear of being left behind in residential care homes, 3) disloyalty and shame of being cared for by outsiders, 4) perceptions about the quality of formal care and 5) concerns about mixing with other cultures and genders. Our findings point to potential barriers beyond culture that influence older Pakistani women's preferences for, expectations of and access to formal care services. The study further highlights the structural barriers that older Pakistani women perceive and experience in accessing formal care services in a majority society.
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Affiliation(s)
- Sanjana Arora
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, N-0130 Oslo, Norway
| | - Melanie Straiton
- Division of Mental and Physical Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213 Oslo, Norway
| | - Astrid Bergland
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, N-0130 Oslo, Norway
| | - Bernd Rechel
- European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - Jonas Debesay
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, N-0130 Oslo, Norway
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